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Heartland virus-associated death in tennessee
Atis Muehlenbachs1, Cynthia R Fata2, Amy J Lambert3
1Infectious Diseases Pathology Branch, Division of High-Consequence Pathogens and Pathology, Centers for Disease Control and Prevention, Atlanta, Georgia.
Summary
Heartland virus (HRTV), a tick-borne illness, caused a fatal outcome in an 80-year-old Tennessee man. This case highlights HRTV
Area of Science:
- Viral Pathogenesis
- Tick-borne Diseases
- Public Health Virology
Background:
- Heartland virus (HRTV) is an emerging tick-borne phlebovirus.
- HRTV infection is associated with fever, leukopenia, and thrombocytopenia.
- The virus is carried by Ambylomma americanum ticks.
Observation:
- The first fatal case of HRTV disease occurred in an 80-year-old Tennessee resident.
- The patient presented with fever, confusion, leukopenia, thrombocytopenia, multiorgan failure, and hemorrhage.
- Ehrlichiosis testing was negative, suggesting a different tick-borne etiology.
Findings:
- Heartland virus (HRTV) antigens were identified in postmortem tissues (spleen, lymph nodes).
- HRTV was detected in premortem blood via RT-PCR and cell culture.
- Immunohistochemistry confirmed HRTV presence in affected organs.
Implications:
- This case confirms that HRTV infection can lead to severe disease and death.
- The geographic range of HRTV has been expanded to include Tennessee.
- This finding underscores the importance of considering HRTV in unexplained febrile illnesses with hematologic abnormalities.
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